Development Of Retinopathy Of Prematurity Research Articles

A Prospective Analysis of the Retinopathy of Prematurity Correlated with the Inflammatory Status of the Extremely Premature and Very Premature Neonates.

Retinopathy of Prematurity (ROP) is a major cause of blindness in premature infants. This study aimed to evaluate the association between inflammatory markers and ROP development in extremely premature and very premature neonates and identify potential inflammatory biomarkers for ROP risk prediction. This prospective study was conducted from January 2021 to January 2023 in two clinical hospitals associated with the "Victor Babes" University of Medicine and Pharmacy Timisoara. The study population comprised neonates with a gestational age of less than 32 weeks. Various inflammatory markers, including total white blood cell count, polymorphonuclear leukocytes, C-reactive protein, interleukin-6, and lactate dehydrogenase, were analyzed from blood samples collected at birth and three days postnatally. ROP was diagnosed and classified following the International Classification of Retinopathy of Prematurity. The study included 48 neonates, 12 Extremely Premature Infants (EPI), and 36 Very Premature Infants (VPI). The EPI group had significantly higher mean interleukin-6 and lactate dehydrogenase levels at birth and three days postnatally than the VPI group. C-reactive protein levels at three days were significantly higher in the VPI group. Umbilical cord inflammation and ROP severity were found to have a statistically significant positive correlation. Half of the EPIs had moderate to severe ROP, significantly more than in the VPI group. The duration of oxygen supplementation, mechanical ventilation, Continuous Positive Airway Pressure (CPAP), gestational age less than 28 weeks, and umbilical cord inflammation at or above stage 3 were significant risk factors for developing ROP stage 2 or above. Elevated CRP and IL-6 were also significantly associated with an increased risk of developing ROP stage 2 or above, highlighting their potential as biomarkers for ROP risk prediction. This study suggests a significant association between inflammatory markers and ROP development in extremely premature and very premature neonates. These findings could contribute to the identification of potential inflammatory biomarkers for ROP risk prediction, improving early diagnosis and intervention strategies for this condition.

Serum Zinc Levels in Preterm Newborns and its Relation with Retinopathy of Prematurity

Background With the increased survival of preterm babies, retinopathy of prematurity (ROP) has become the leading cause of preventable childhood blindness. It is caused by oxidative damage to the immature retina and zinc may help in the prevention of ROP owing to its antioxidant properties. Objective To measure serum zinc levels in preterm neonates and study its association with the development of ROP. Methods A total of 360 preterm neonates of gestational age between 28 completed weeks to <37 weeks were included in this observational cross-sectional study. Serum zinc levels of the neonates aging <24 hours of life were measured at the time of admission in NICU by spectrophotometry. Taking the reference range of serum zinc levels between 70 to 150 mcg/dL babies were arbitrarily divided into 2 groups (<70 and >70 mcg/dL). ROP screening was done at appropriate postnatal age by indirect ophthalmoscopy. The results were analyzed by the SPSS software version. Results The mean serum zinc level was 114.99±54.47 mcg/dL. The overall prevalence of ROP was 26%; of which, 10% of neonates had severe ROP (≥stage 3). A significant association was found between gestational age and birth weight with ROP. Oxygen supplementation, respiratory distress syndrome, surfactant use, antibiotic use >7 days, and low serum zinc levels (<70 mcg/dL) were significant risk factors on univariate analysis and after multivariate analysis, gestational age, surfactant use, and low serum zinc levels (<70 mcg/dL) came out to be independent risk factors for ROP. Conclusion There was a statistically significant association of low serum zinc levels with the development of ROP and it was independent of other risk factors associated with ROP.

Association between fetal growth-restriction and retinopathy of prematurity using a unique identical twin model.

Research in singletons identified fetal growth restriction (FGR) as a risk factor for retinopathy of prematurity (ROP), but is generally subject to confounding by genetic, obstetric, and maternal factors. We investigated the effect of FGR on ROP in growth-discordant identical twins, thereby controlling for confounding factors. All data of monochorionic (MC) twin pairs with a birth weight discordance ≥20% born in our center between 2010 and 2021 were retrospectively reviewed for the presence of ROP. Potential risk factors for ROP were analyzed. Outcomes were compared between the smaller and larger twin. We included 88 MC twin pairs with growth discordance. In 34% (30/88), both neonates were at risk of ROP. Prevalence of ROP was higher among the smaller twin compared to the larger twin, 30% (9/30) versus 13% (4/30), respectively (OR 2.8, 95% CI: 1.2-6.6). The smaller twin had a longer duration of mechanical ventilation (8 (1-20) versus 2 (1-4) days) and received their first red blood cell transfusion at an earlier postmenstrual age (29.6 (28.1-31.6) versus 30.4 (29.7-32.6) weeks). In this identical twin model, FGR is associated with almost tripled odds of ROP development, suggesting that both unfavorable antenatal growth conditions and adverse neonatal outcomes affect postnatal retinal vascular proliferation. Fetal growth restriction in growth-discordant identical twins is associated with almost tripled odds of developing retinopathy of prematurity in the smaller twin. Since these twins do not only differ in birth weight but also duration of mechanical ventilation and timing of the first red blood cell transfusion, both unfavorable antenatal growth conditions and adverse neonatal outcomes can affect postnatal retinal vascular proliferation. More attention for preventing retinopathy of prematurity is needed in those with fetal growth restriction who received prolonged duration of mechanical ventilation, oxygen supplementation, or a first red blood cell transfusion <32 weeks postmenstrual age.

Nailfold Capillaroscopy: A Promising, Noninvasive Approach to Predict Retinopathy of Prematurity

To test the hypothesis that nailfold capillaroscopy can noninvasively detect dysregulated retinal angiogenesis and predict retinopathy of prematurity (ROP) in infants born premature before its development. In a cohort of 32 infants born <33weeks of gestation, 1386 nailfold capillary network images of the 3 middle fingers of each hand were taken during the first month of life. From these, 25 infants had paired data taken 2 weeks apart during the first month of life. Images were analyzed for metrics of peripheral microvascular density using a machine learning-based segmentation approach and a previously validated microvascular quantification platform (REAVER vascular analysis). Results were correlated with subsequent development of ROP based on a published consensus ROP severity scale. In total, 18 of 32 (56%) (entire cohort) and 13 of 25 (52%) (2-time point subgroup) developed ROP. Peripheral vascular density decreased significantly during the first month of life. In the paired time point analysis, vessel length density, a key metric of peripheral vascular density, was significantly greater at both time points among infants who later developed ROP (15 563 and 11 996μm/mm2, respectively) compared with infants who did not (12 252 and 8845μm/mm2, respectively) (P<.001, both time points). A vessel length density cutoff of >15 100 at T1 or at T2 correctly detected 3 of 3 infants requiring ROP therapy. In a mixed-effects linear regression model, peripheral vascular density metrics were significantly correlated with ROP severity. Nailfold microvascular density assessed during the first month of life is a promising, noninvasive biomarker to identify premature infants at highest risk for ROP before detection on eye exam.

TRENDS OF RETINOPATHY OF PREMATURITY IN A TERTIARY CARE CENTRE IN URBAN INDIA

Introduction: Retinopathy of prematurity is the leading cause of preventable blindness in premature infants. Our study aims at nding the Incidence and severity of Retinopathy of prematurity (ROP) and its association with various risk factors like low gestational age, low birth weight, oxygen exposure, respiratory distress syndrome, sepsis, blood transfusion and intraventricular hemorrhage. This is a prospective observational study conducted in a tertiary ca Methods: re teaching hospital in Western Maharashtra. Patient data including systemic and ocular ndings were documented. Incidence and severity of ROP was calculated and the association of various risk factors with ROP was calculated using Chi-square test. Among the 266 babies i Results: ncluded in study, the Incidence of ROP was found to be 13.50% and Type I disease was found in 1.31%. The mean birth weight of neonates with ROP was 1230.2 ± 479.5 g and the mean gestational age was 30.27 ± 2.87 weeks. Development of ROP was signicantly associated with low gestational age (GA), low birth weight (BW) and Respiratory Distress Syndrome (RDS). Early screening of preterm babies is crucial Conclusion: for early diagnosis and treatment of ROP to prevent its sight threatening complications

Potential Role of Bilirubin in Preventing Retinopathy of Prematurity.

One of the most common problems in preterm neonates is retinopathy of prematurity (ROP). It has been shown antioxidants may be effective in preventing the development and progression of ROP. Considering the antioxidant properties of bilirubin, we decided to investigate the bilirubin level in neonates with ROP and compare it with healthy neonates. This case-control study was performed on VLBW neonates admitted to the NICU of Ghaem Hospital in Mashhad between 2014 and 2020 for a Jaundice evaluation. Complete neonate's characteristics, maternal history and laboratory results were collected in a questionnaire. Then the neonates were examined for ROP by a fellowship of the retina of an ophthalmologist at 32 weeks or four weeks after birth. The highest bilirubin levels during their hospitalization were also recorded. Of 427 neonates examined, 121 (37.7%) had a normal eye examination, and 266 (62.3%) had ROP. The mean weight, gestational age and bilirubin were 1455.8 ± 431.4 grams, 31.6 ± 2.3 weeks and 8.8 ± 2.4 mg/dl, respectively. There was a significant difference between controls and neonates with ROP with regard to birth weight, duration of intermittent positive pressure ventilation (IPPV), duration of oxygen therapy, first and fifth minute Apgar scores, the maximum level of bilirubin and gestational age (P < 0.05). It was observed that the maximum level of bilirubin was lower in neonates with higher stages of ROP. According to the results of this study, higher levels of bilirubin in neonates may be a protective factor against ROP. Moreover, increased levels of bilirubin are associated with reduced severity of ROP. Therefore, prophylaxis phototherapy in premature infants may need to be reconsidered.

Demographics and Clinical Patterns of Retinopathy of Prematurity at the University of Teaching Hospitals, Women and Newborn Hospital

Background: Retinopathy of prematurity (ROP) is a disorder of the developing retina of very low birth weight (VLBW) preterm infants. It is an important cause of childhood blindness and is listed as one of the causes of avoidable blindness in the vision 2020 - “The Right to Sight” Programme.&#x0D; ROP is more prevalent in highly developed countries where neonatal services’ availability, access and outcomes are good. The survival rates of Very low Birth Weight (VLBW) infant and low gestational age (GA) at the University Teaching Hospital (UTH), Women and Newborn Hospital (WNH) Neonatal Intensive Care Unit has improved.&#x0D; Aims: To estimate the prevalence of ROP at UTH, WNH, NICU.&#x0D; Study Design: Hospital-based cross-sectional study.&#x0D; Place and Duration: Neonatal Intensive Care Unit, Women and Newborn hospital at the University Teaching Hospital, in Lusaka, Zambia between November 2021 to April 2022.&#x0D; Methodology: We included 110 (54.5% males and 45.5% females) infants either born at &lt;32 weeks GA or weighed &lt;1500g. Dilated fundus examinations were done at 4 to 6 weeks chronological age or 31 to 33 weeks GA. Medical records were reviewed to identify associated factors.&#x0D; Results: Mean gestational age at birth was 30.6±2 weeks ranging from 27 to 34 weeks, mean birth weight was 1422.7±334.3 g ranging from 900g to 2200 g, mean Apgar score at 1 minute was 7±1.3, at 5 minutes the mean was 7.8±0.9, and at 10 minutes the mean was 8.4±0.7. Twenty-six (23.6%) were products of multiple gestations. Hyaline membrane disease was observed in 14 (12.7%), neonatal sepsis in 48 (43.6%), necrotising enterocolitis in 6 (5.5%), patent ductus arteriosus in one (0.9%), and hyperglycaemia in 56 (50.9%) cases.&#x0D; Conclusion: Our study found no participant with retinopathy of prematurity at UTH NICU. Further, the study could not make associations between suggested risk factors to the development of ROP. However, being a novel study on this topic in the country, it highlights the importance of setting up screening protocols and their attendant equipment in Special Care Baby Units at UTH and improving neonatal care services.

Increased Risk of Retinopathy of Prematurity in Donors with Twin-to-Twin Transfusion Syndrome: A Cohort Study

Introduction: The purpose of this study was to evaluate the within-pair difference in retinopathy of prematurity (ROP) between donors and recipients with twin-to-twin transfusion syndrome (TTTS) and to identify risk factors for ROP development. Methods: This retrospective cohort study included 147 TTTS twin pairs managed between 2002 and 2022 and eligible for ROP screening. Primary outcomes were any stage ROP and severe ROP. Secondary outcomes were hemoglobin at birth, red blood cell transfusions, mechanical ventilation days, postnatal steroids, and neonatal morbidity. Donor status was defined as having polyhydramnios pre-laser. Results: Rates of any stage ROP (23% vs. 14%) and severe ROP (8% vs. 3%) were significantly higher in donors compared to recipients. Donors received a higher number of blood transfusions (1 [±1.9] versus 0.7 [±1.5]). Five factors were univariately associated with any stage ROP: donor status (odds ratio [OR] 1.9; 95% CI 1.3–2.9), lower gestational age (GA) at birth (OR 1.7; 95% CI 1.4–2.1), small for GA (OR 2.1; 95% CI 1.3–3.5), mechanical ventilation days (OR 1.1; 95% CI 1.1–1.2), and blood transfusions in phase 1 (OR 2.3; 95% CI 1.2–4.3). Three factors were independently associated with any stage ROP: donor status (OR 1.8; 95% CI 1.1–2.9), lower GA at birth (OR 1.6; 95% CI 1.2–2.1), and mechanical ventilation days (OR 1.1, 95% CI 1.0–1.1). Donor status was univariately associated with severe ROP (OR 2.3, 95% CI 1.1–5.0). Conclusion: Any stage ROP and severe ROP are detected twice as frequently in donors compared to recipients. Increased awareness for ROP is needed in donors, especially those with lower GA at birth and longer duration of mechanical ventilation.

Optical Coherence Tomography and Optical Coherence Tomography Angiography in Pediatric Retinal Diseases

Indirect ophthalmoscopy and handheld retinal imaging are the most common and traditional modalities for the evaluation and documentation of the pediatric fundus, especially for pre-verbal children. Optical coherence tomography (OCT) allows for in vivo visualization that resembles histology, and optical coherence tomography angiography (OCTA) allows for non-invasive depth-resolved imaging of the retinal vasculature. Both OCT and OCTA were extensively used and studied in adults, but not in children. The advent of prototype handheld OCT and OCTA have allowed for detailed imaging in younger infants and even neonates in the neonatal care intensive unit with retinopathy of prematurity (ROP). In this review, we discuss the use of OCTA and OCTA in various pediatric retinal diseases, including ROP, familial exudative vitreoretinopathy (FEVR), Coats disease and other less common diseases. For example, handheld portable OCT was shown to detect subclinical macular edema and incomplete foveal development in ROP, as well as subretinal exudation and fibrosis in Coats disease. Some challenges in the pediatric age group include the lack of a normative database and the difficulty in image registration for longitudinal comparison. We believe that technological improvements in the use of OCT and OCTA will improve our understanding and care of pediatric retina patients in the future.

Effect of blood sampling management on reducing blood transfusions in very preterm infants.

Effect of blood sampling management on reducing blood transfusions in very preterm infants.

Роль проблем пренатального периода в развитии ретинопатии недоношенных. Часть 2

Purpose. Identification of prenatal factors influencing on the retinopathy of prematurity (ROP) development and severity of its course. Material and methods. A retrospective analysis of 90 case histories of premature patients was carried out. There were 3 groups of clinical trials: children without ROP development (30 children), children with ROP development with severe course of type I, requiring surgical treatment (30 children) and children with type II ROP that ended in spontaneous regression (30 children). Results. The detection of cervical ectopia in the mother can potentially be used as a risk factor for predicting the development of ROP and its severe course during screening. The presence of miscarriages in the mother’s obstetric history is associated with a high risk of ROP requiring surgical treatment. Maternal history of medical abortion does not significantly affect the risk of developing ROP in a premature newborn. The presence in the anamnesis of a mother of an undeveloped (missed) pregnancy is a risk factor for the development of ROP and its severe course in a premature baby. Threatened abortion in the 1st trimester and its treatment with progesterone analogues are associated with a reduced risk of developing ROP and a decrease in its severity. The development of preeclampsia is not associated with a high risk of developing and severe ROP. Somatic pathology, maternal hypertension and a history of hepatitis do not affect the development of ROP. Conclusion. The presence of an ectopic cervix in the mother, miscarriages and undeveloped pregnancy in an obstetric history are prenatal risk factors for retinopathy of prematurity. Key words: prenatal risk factors, retinopathy of prematurity, premature baby, cervical ectopia, miscarriage, missed pregnancy, preeclampsia

Hematologic Risk Factors for the Development of Retinopathy of Prematurity—A Retrospective Study

(1) Background: Retinopathy of prematurity (ROP) can cause severe visual impairment or even blindness. We aimed to assess the hematological risk factors that are associated with different stages of ROP in a cohort of preterm newborns, and to compare the clinical characteristics and therapeutic interventions between groups. (2) Methods: This retrospective study included 149 preterm newborns from a tertiary maternity hospital in Romania between January 2018 and December 2018, who were segregated into: Group 1 (with ROP, n = 59 patients), and Group 2 (without ROP, n = 90 patients). The patients that were affected by ROP were subsequently divided into the following subgroups: Subgroup 1 (Stage 1, n = 21), Subgroup 2 (Stage 2, n = 35), and Subgroup 3 (Stage 3, n = 25). The associations were analyzed using multivariate logistic regression and sensitivity analysis. (3) Results: Platelet mass indexes (PMI) that were determined in the first, seventh, and tenth days of life were significantly associated with Stage 1 ROP. PMI determined in the first day of life was also significantly associated with Stage 2 ROP. The sensitivity and specificity of these parameters were modest, ranging from 44 to 57%, and 59 to 63%. (4) Conclusions: PMI has a modest ability to predict the development of ROP.

Association of umbilical cord insulin-like growth factor 1 levels with severe retinopathy in extremely preterm infants.

The association between umbilical cord blood insulin-like growth factor 1 (IGF-1) levels and retinopathy of prematurity (ROP) remains unclear. This study aimed to investigate whether umbilical cord blood IGF-1 levels can predict the development of severe ROP in extremely preterm infants. This hospital-based retrospective cohort study included infants born at <37 weeks gestational age (GA) between 2019 and 2021 and then classified them into the two GA groups: extremely preterm, <28 weeks and preterm infants, 28-36 weeks. Extremely preterm infants were further subclassified into two groups according to the laser treatment as follows: the severe ROP (ROP-Tx) and ROP (No ROP-Tx) groups. Median umbilical cord blood IGF-1 values were compared between the groups. Perinatal risk factors were identified by univariate and multivariate analyses. Finally, umbilical cord IGF-1 cut-off values requiring ROP treatment with laser were determined by receiver operating characteristic (ROC) curve analyses. A total of 205 infants were enrolled, with 32 being extremely preterm (ROP-Tx: n=11; No ROP-Tx: n=21) and 173 being preterm. IGF-1 levels were significantly lower in extremely preterm (13.5ng/mL) than preterm infants (36ng/mL, p<0.001). In extremely preterm infants, IGF-1 levels were significantly lower in the ROP-Tx group than the No ROP-Tx group (10 vs. 19ng/mL, respectively, p=0.024). Only GA, umbilical cord blood IGF-1 levels, birth head circumference, and birth chest circumference were identified as risk factors by univariate analysis (p<0.05). Multivariate analysis showed that only umbilical cord blood IGF-1 was an independent risk factor (odds ratio: 1.26, p=0.021). ROC curves revealed an IGF-1 cut-off value of 14ng/mL. The need of laser treatment for ROP was found to be associated with low umbilical cord blood IGF-1 levels in extremely preterm infants. Umbilical cord blood IGF-1 can be used as a biomarker for the risk of developing severe ROP.

Prevalence of Retinopathy of Prematurity in Premature Neonates Visiting Sir Gangaram Hospital Lahore

Background: Retinopathy of prematurity (ROP) is a serious problem which affects the premature infants. It is becoming a public health issue in developing countries like Pakistan. Antenatal visits, delivery and NICU management plays an important role in prevention of ROP. Objective: The aim of this study was to find out the prevalence of retinopathy of prematurity in premature neonates visiting Sir Ganga Ram hospital Lahore. Study Design: observational study. Settings: Study was carried out in Out-patient of Ophthalmology Department, A public sector Sir Ganga Ram Hospital, Lahore Pakistan. Duration: The duration of the study was one year from September 2020 to August 2021. Methods: All the preterm babies referred from pediatric department were part of study. A total of 160 babies were examined in this study. The data was presented in the form of frequency and percentages using SPSS software. Results: In this study out of 160 patients 75(46.87%) were male and 85(53.12%) were females. The prevalence of retinopathy of prematurity was observed in 43(26.87%) babies. Weight of patients less than 1kg was 11(25.58%) between 1-1.5 kg was noted in 28(65.11%) patients and &gt;2 kg weight was noted in 4(9.30%) patients. Babies with ROP, 23(53.48%) recovered without any intervention, 9(20.93%) required intervention and recovered after 3 months follow up, 6(13.95%) kept under observation and recovered after 4 months and 5(11.62%) babies lost follow up. Practical implication: this study will help in early diagnosis and prevention of disease and help to formulate and introduce newer guidelines for prevention, early identification and prompt treatment starting from basic levels to prevent development of ROP of any stage. Conclusion: The study concluded that the prevalence of retinopathy of prematurity in premature neonates visiting Sir Ganga Ram hospital Lahore is 27%. Keywords: Retinopathy of Prematurity(ROP), Neonates, Preterm, screening, blindness

Characteristic and risk factors of retinopathy of prematurity in Sanglah Hospital Denpasar: 3-years retrospective study

Introduction: Retinopathy of prematurity (ROP) is one of the important causes of blindness in children. ROP is characterized by abnormal retinal neovascularization of premature infants. Purpose: This study aimed to estimate the prevalence of ROP in preterm infants at Sanglah Hospital Bali from 2015-2017 and identify the risk factors predisposing them to ROP. Methods: This was a retrospective study, observational analysis on premature infants diagnosed as ROP at Sanglah Hospital Bali from January 2015 to December 2017, with a gestational age of 30 weeks or less at birth and a birth weight of 1500 grams or less. Infants whose gestational age was &gt;30 weeks or whose birth weight was &gt;1500 grams were also included. The ophthalmological examinations were initiated between the fourth and sixth weeks of chronological age or 34 weeks of corrected age, whichever was earlier, and were repeated weekly or biweekly as per Indonesian guidelines for ROP screening, until full vascularization of the retina reached zone 3. Results: Out of 31 infants diagnosed as ROP, 3 (9.7%) cases developed ROP in one eye, and 28 (90,3%) cases in both eyes. They were classified as 23 (74.2%) cases stage 1, and 8 (25,8%) cases stage 2. None of the studied infants presented ROP at stage 3, 4, or 5. The risk for ROP was not significantly associated with birth weight (OR 0.375; 95% CI 0.030 – 4.635), gestational age (OR 0.897; 95% CI 0.792 – 1.015), sepsis (OR 1.111; 95% CI 0.089 – 13.835), blood transfusion (OR 1.111; 95% CI 0.089 – 13.835), and HMD (OR 1.118; 95% CI 0.977 – 1.443). Conclusions: The data of this study showed that low gestational age, low birth weight, sepsis, oxygen therapy, and blood transfusion may be contribute to the development of ROP, but not significant statistically. Clinicians should be aware of the presence of the additional risk factors when monitoring preterm infants,especially when giving supplemental oxygen therapy.

Potential role of eNOS and EDN-1 gene polymorphisms in the development and progression of retinopathy of prematurity

The aim of this study was to investigate the association between selected polymorphisms of nitric oxide synthetase (eNOS) and endothelin-1 (EDN-1) with the occurrence and progression of retinopathy of prematurity (ROP). A prospective study was conducted on 90 preterm infants (44 female), comparing 39 cases with ROP and 51 controls without ROP. Patients who developed ROP were further divided into two subgroups—those with spontaneous regression of the disease and those with ROP requiring treatment. We found that preterm infants with TT genotype eNOS 894G > T had a 12.8-fold higher risk of developing ROP requiring treatment (p = 0.02). Our results showed that allele T of eNOS894G > T polymorphism was significantly more prevalent in ROP patients requiring treatment (p = 0.029). We also investigated preterm infants with TC genotype eNOS − 786 T > C and found an 8.8-fold higher risk developing of ROP requiring treatment (p = 0.021). Our results didn’t show any association between EDN-1 5665G > T polymorphism and ROP development. The eNOS polymorphisms appears to influence incidence of ROP requiring treatment in preterm infants. Future research on single nucleotide polymorphisms may provide important information about the pathogenetic mechanisms underlying the development of ROP.

Placental Inflammation Significantly Correlates with Reduced Risk for Retinopathy of Prematurity

Retinopathy of prematurity (ROP), a blinding condition affecting preterm infants, is an interruption of retinal vascular maturation that is incomplete when born preterm. Although ROP demonstrates delayed onset following preterm birth, representing a window for therapeutic intervention, there are no curative or preventative measures available for this condition. The in utero environment, including placental function, is increasingly recognized for contributions to preterm infant disease risk. The current study identified a protective association between acute placental inflammation and preterm infant ROP development using logistic regression, with the most significant association found for infants without gestational exposure to maternal preeclampsia and those with earlier preterm birth. Expression analysis of proteins with described ROP risk associations demonstrated significantly decreased placental high temperature requirement A serine peptidase-1 (HTRA-1) and fatty acid binding protein 4 protein expression in infants with acute placental inflammation compared with those without. Within the postnatal peripheral circulation, HTRA-1 and vascular endothelial growth factor-A demonstrated inverse longitudinal trends for infants born in the presence of, compared with absence of, acute placental inflammation. An agnostic approach, including whole transcriptome and differential methylation placental analysis, further identify novel mediators and pathways that may underly protection. Taken together, these data build on emerging literature showing a protective association between acute placental inflammation and ROP development and identify novel mechanisms that may inform postnatal risk associations in preterm infants.

Incidence and Risk Factors for Retinopathy of Prematurity at a Rural Tertiary Hospital in Thailand.

To estimate the incidence and identify the factors affecting retinopathy of prematurity (ROP) in a rural tertiary hospital in Thailand. This retrospective chart review included all infants screened for ROP. The study included all infants with gestational age (GA) 30 weeks or birth weight (BW) 1,500 gr or selected larger infants with an unstable clinical course. Retinal findings were classified according to the revised International Classification of ROP. Data were analyzed using univariate and multivariable logistic regression analyses. Of the 113 screened infants, the incidences of any ROP and ROP requiring intervention were 17.7% and 8.8%, respectively. In univariate analysis, lower GA, lighter BW, total days of supplemental oxygen, days of continuous positive airway pressure (CPAP), presence of apnea, and intraventricular hemorrhage (IVH) were associated with the development of any ROP. In the stepwise multivariable logistic regression analysis, lighter BW, male gender, and bronchopulmonary dysplasia (BPD) were significant risk factors for the development of any ROP. Lower GA and being either a twin or triplet were significant risk factors for ROP requiring intervention. However, no antenatal condition was identified as a risk factor for ROP. The incidence of ROP in rural tertiary hospitals was relatively high as compared with previously published data from urban tertiary hospitals. Lighter BW, male gender, and BPD were significantly associated with the development of ROP in a local context. Epidemiological studies are necessary to prevent ophthalmic morbidities.

Validation of the East London Retinopathy of Prematurity algorithm to detect treatment-warranted retinopathy of prematurity: a cohort study

AimTo validate the East London Retinopathy of Prematurity algorithm (EL-ROP) in a cohort of infants at risk of developing retinopathy of prematurity (ROP).MethodsThe EL-ROP algorithm was applied retrospectively to routinely...

Оптимизация ранней диагностики развития и прогрессирования ретинопатии недоношенных

Purpose. To develop easy-to-use methods for early diagnosis of the development and progression of retinopathy of prematurity (ROP). Мaterial and methods. The extracellular peroxidase activity (EPA) of blood serum was studied by spectrophotometry in 93 premature newborns aged 3–4 weeks of life and the thickness of the retinal neuroepithelium (NES) of the paramacular zone by measuring it at a distance of 500 μm from the border of the foveola in 82 premature infants (162 eyes ) using optical coherence tomography (OCT) of the retina on the RetinaScan — 3000 device (NIDEK) in the Macula Multi Cross mode. Results. Determination in premature newborns at 3–4 weeks of life of the level of blood serum VPA less than 1887.1 c.u. allows predicting the development of ROP in 76.4 % of cases. At the same time, there is an inverse correlation (R = –0.94; p &lt; 0.05) between the value of the VPA and the pathology of the upper respiratory tract (respiratory distress syndrome, respiratory failure, asphyxia). The study of the thickness of the paramacular zone of NES showed an increase in its values, regardless of the stage and form of ROP. At the same time, the average thickness index was higher by 39.0 μm in infants with ADHD compared with stage I of the classical form, by 39.3 μm — by stage II, by 35.8 μm — by stage III (p &lt; 0.05). Stabilization of the pathological process was accompanied by a decrease in the NES thickness index (p &lt; 0.05). Conclusion. Examination of the values of extracellular peroxidase activity in the blood serum at 3–4 weeks of life of a premature newborn, as well as monitoring the thickness of the retinal neuroepithelium in the paramacular zone, allow timely diagnosis of retinopathy of prematurity. Keywords: retinopathy of prematurity, diagnostics, extracellular peroxidase activity, retinal neuroepithelial thickness